EP2030623A1 - Preventing and/or treating metabolic disorders by modulating the amount of enterobacteria - Google Patents
Preventing and/or treating metabolic disorders by modulating the amount of enterobacteria Download PDFInfo
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- EP2030623A1 EP2030623A1 EP07114530A EP07114530A EP2030623A1 EP 2030623 A1 EP2030623 A1 EP 2030623A1 EP 07114530 A EP07114530 A EP 07114530A EP 07114530 A EP07114530 A EP 07114530A EP 2030623 A1 EP2030623 A1 EP 2030623A1
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- enterobacteria
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Definitions
- the present invention relates to the prevention and/or treatment of metabolic disorders.
- the present invention relates to preventing and/or treating metabolic disorders by modulating, in particular reducing the amount of enterobacteria in the gut.
- Human beings are superorganisms with a body composed of millions of human cells while many more bacteria live, e.g., in the colon. It has been estimated that more than 10 13 to 10 14 bacteria are alive in a healthy human intestine. Intestinal bacteria can be separated into 2 major divisions, firmicute s and bacteroidete s ( Steven R. Gill,et al., Science 2006 June 2;312: 1355-1359 ; Peter J. Turnbaugh, et al., Nature 2006 Dec 21;444:1027-131 ). Together, they represent at least 90% of total bacterial population in the gut.
- the presence of the gut bacteria is a part of normal human physiology and is important for the development of gut functions ( Hooper LV et al., Science. 2001 Feb 2;291(5505):881-4 ; Stappenbeck TS, et al., Proc Natl Acad Sci U S A. 2002 Nov 26;99(24):15451-5 ), maturation of the immune system ( Mazmanian SK, et al., Cell. 2005 Jul 15;122(1):107-18 ), harvesting energy from dietary carbohydrates ( Peter J. Turnbaugh, et al., Nature 2006 Dec 21;444:1027-131 ), harvesting essential vitamins ( Backhed F, et al., Science.
- One important aspect of the present invention is to understand the influences of different gut bacteria to human health. The inventors were surprised to find that benefits in the treatment and/or prevention of metabolic disorders, in particular weight control and treatment of type 2 diabetes, can be achieved when gut enterobacteria are specifically reduced.
- one aspect of the present invention is to reduce specifically the enterobacteria in the gut is to treat and/or prevent metabolic disorders, in particular to reduce weight gain and improve glucose control in type 2 diabetes.
- One embodiment of the present invention relates consequently to the use of a primary composition comprising an agent that reduces the amount of enterobacteria in the gut for the preparation of a composition to treat or prevent metabolic disorders.
- reducing the amount of enterobacteria in the gut means “reducing the amount of alive enterobacteria in the gut”.
- “Reducing the amount of enterobacteria in the gut” may also include reducing the total amount of enterobacteria, dead or alive, in the gut.
- “Reducing the amount of enterobacteria in the gut” may also relate to “reducing the amount of dead enterobacteria in the gut.
- Enterobacteria are preferably firmicute and/or bacteroidete.
- enterobacteria may be selected from the group consisting of Alishewanella, Alterococcus, Aquamonas, Aranicola, Arsenophonus, Azotivirga, Blochmannia, Brenneria, Buchnera, Budvicia, Buttiauxella, Cedecea, Citrobacter, Dickeya, Edwardsiella, Enterobacter, Erwinia, Escherichia, Ewingella, Grimontella, Hafnia, Klebsiella, Kluyvera, Leclercia, Leminorella, Moellerella, Morganella, Obesumbacterium, Pantoea, Pectobacterium, Candidatus Phlomobacter, Photorhabdus, Plesiomonas, Pragia, Proteus, Providencia, Rahnella, Raoultella, Salmonella, Samsonia, Serratia, Shigella, Sodalis, Tatumella, Trabulsiella, Wigglesworthia, X
- metabolic disorders that can be treated or prevented by the above use include obesity, insulin resistance, type-2 diabetes, hyperglycemia, hepatic steatosis and combinations thereof.
- the use of the present invention is further applicable to treat or prevent weight gain.
- Olesity is a condition in which the natural energy reserve, stored in the fatty tissue of animals, in particular humans and other mammals, is increased to a point where it is associated with certain health conditions or increased mortality. "Obese” is defined for an adult human as having a BMI greater than 30.
- Probiotic means microbial cell preparations or components of microbial cells with a beneficial effect on the health or well-being of the host.
- Prebiotic means food substances intended to promote the growth of probiotic bacteria in the intestines.
- prebiotics is dietary fibers. Dietary fibers are fibers that are non-digestible by the human body.
- Food grade bacteria means bacteria that are used and generally regarded as safe for use in food.
- the composition of the present invention may be any composition, for example it may be a medicament.
- a medicament usually requires supervision by medical personnel, a medicament has the advantage that the success of the use of the present invention can be carefully monitored and -if necessary- the composition can be custom fitted to the needs of the patient to be treated.
- the composition is a food product.
- Food products have the advantage that the benefits of the present invention would be available to everybody immediately without requiring a medical prescription. The treatment or prevention of metabolic disorders could be initiated at a much earlier stage. Further in a food product the composition prepared by the use of the present invention would be even more pleasant to consume.
- the food product or the medicament prepared by the use of the present invention may be intended for humans or animals, in particular pets or livestock.
- Animals may be selected from the group consisting of dogs, cats, pigs, cattle, horses, goats, sheep or poultry.
- metabolic disorders are no longer a problem that only concerns the adult population.
- compositions prepared by the use of the present invention may be intended for infants, children, adolescents and/or adults.
- compositions of the present invention exhibit their beneficial effects at any age of the subject to be treated. Since, however, metabolic disorders are still found mainly in the adult population, it is preferred that the composition prepared by the use of the present invention is intended for adult patients, in particular human adults.
- the idea of reducing enterobacteria in the gut is the idea of reducing enterobacteria in the gut. Consequently, any agent or method that is capable of reducing enterobacteria in the gut can be used for the purpose of the present invention. It is preferred, however that the agent capable of reducing the amount of enterobacteria in the gut is selected from the group consisting of bacterial phages, prebiotics, food grade bacteria, in particular probiotics, yeasts, phytochemicals, antibiotics and mixtures thereof.
- the phages are food grade phages.
- T4 phages such as ED6, and T7 phages can be successfully applied in the framework of the present invention.
- Phages have the advantage that they are very specific to targeted bacteria and very stable even after long storage times without losing biological activities.
- the heat stability of phages makes them suitable for food products that are heated during the production process or during preparation prior to consumption.
- phagse are stable in a number of different media, including the stomach and gut media.
- Prebiotics may be dietary fibers.
- Dietary fibers may be selected from the group consisting of fructo-oligosaccharides, galacto-oligosaccharides, xylo-oligosaccharides, isomalto-saccharides, soya oligosaccharides, pyrodextrins, transgalactosylated oligosaccharides, lactulose, beta-glucan, inulin, raffinose, stachyose. Dietary fibers also have the advantage of being resistant to a number of conditions including heating and long storage times. They furthermore may contribute to a treatment in the framework of the present invention by improving gastrointestinal health and by increasing satiety.
- Food grade bacteria are preferably probiotic bacteria and may be selected from the group consisting of Bifidobacterium, lactococcus, streptococcus, enterococcus, lactobacillus; preferentially lactic acid bacteria and bifidobacteria, or mixtures thereof.
- Yeasts are preferably food grade yeasts and may be selected from the group consisting of saccharomyces boulardii and saccharomyces cerevisiae or mixtures thereof.
- Food grade bacteria, in particular probiotic bacteria and food grade yeasts have the advantage that they may additionally confer benefits to the patient, in particular to the intestinal flora of the patient. These additional benefits are generally known to those skilled in the art and may include managing lactose intolerance, prevention of colon cancer, lowering cholesterol, lowering blood pressure, improving immune function and preventing infections, reducing inflammation and/or improving mineral absorption.
- Antibiotics may be selected from the group consisting of a class of aminoglycoside antibiotics such as neomycin, kanamycin, streptomycin, a class of polypeptide antibiotics such as polymyxin B, a class of penicillin beta-lactam such as ampicillin and a class of quinolone/fluoroquinolone antibiotics such as ciprofloxacin and norfloxacin.
- a class of aminoglycoside antibiotics such as neomycin, kanamycin, streptomycin
- polypeptide antibiotics such as polymyxin B
- penicillin beta-lactam such as ampicillin
- quinolone/fluoroquinolone antibiotics such as ciprofloxacin and norfloxacin.
- the agent capable of reducing the amount of enterobacteria in the gut may also be a phytochemical, in particular a phytonutrient.
- Phytochemicals are plant or fruit derived chemical compounds. "Phytonutrients" refer to phytochemicals derived from edible plants. Using phytonutrients and or phytochemicals has the advantage that the effect of the present invention can be achieved with natural foods or extracts from natural foods without having to add synthesized compounds to the composition prepared by the use of the present invention.
- the phytochemicals may be selected from the group consisting of phytochemicals from green tea or coffee such as indole, polyphenols, such as epigallocatechin and epigallocatechin gallate or the polymers of such, phytochemicals from black tea such as theaflavin or theaflavin mixtures, tennic acid, procyanidin, phytochemicals from cashew apple flavour such as (E)-2-hexenal, phytochemicals from rosemary, such as carnosol, carnosic acid or rosmarinic acid, or mixtures thereof.
- the primary composition may further comprise a pharmaceutically acceptable carrier.
- Applicable pharmaceutically acceptable carriers are known to those of skill in the art.
- the pharmaceutically acceptable carrier may be any carrier known in the field as suitable for pharmaceutical and/or oral application. Suitable pharmaceutical carriers and formulations may include sugars and starches. Additional examples of pharmaceutically acceptable carriers are described, for example, in Remington's Pharmaceutical Sciences (19th ed.) (Genarro, ed. (1995) Mack Publishing Co., Easton, Pa .), the contents of which is herewith incorporated herein by reference..
- the addition of a carrier has the advantage that the agent capable of reducing the amount of enterobacteria in the gut is further stabilized for long storage times. Furthermore, exact dosing is facilitated.
- composition prepared by the use of the present invention may also be formulated as sustained release formulation. This way an increased bioavailability and effectiveness of the agent capable of reducing the amount of enterobacteria in the gut can be achieved.
- the dosage of the agent capable of reducing the amount of enterobacteria in the gut can be adjusted by those skilled in the art to the designated purpose. Any dose showing an effect is suitable. However, e.g., for probiotic bacteria it is preferred that the composition comprises between 10 2 and 10 12 cells of probiotic per g of the dry weight of the composition. Importantly, for the effectiveness of the agent capable of reducing the amount of enterobacteria in the gut it is not necessarily required that the probiotic bacteria are alive in the composition.
- the probiotics might also be effective, e.g., by means of their metabolites that they have produced. Using inactive probiotics has the advantage that the amount of active agent can be exactly determined. Furthermore, inactive probiotics are usually very storage stable and easy to incorporate in products.
- the composition comprises between 10 2 and 10 12 cfu of probiotic per g of the dry weight of the composition. Similarly, it is preferred that the composition comprises between 10 2 and 10 12 pfu of phages per g of the dry weight.
- composition may also comprise between 1 ⁇ g - 500 mg prebiotics per g of the dry weight.
- composition may comprise between 1 ⁇ g - 100 mg antibiotics per g of the dry weight.
- composition may comprise between 1 ⁇ g - 500 mg phytochemicals per g of the dry weight.
- composition that is prepared by the use of the present invention is a liquid, in particular a drink
- the given amounts should be understood as per g of the final product instead of per g of dry weight.
- the agents capable of reducing the amount of enterobacteria in the gut may be combined.
- Typical food products that may be prepared in the framework of the present invention may be selected from the group consisting of milk-powder based products; instant drinks; ready-to-drink formulations; nutritional powders; milk-based products, in particular yoghurts or ice cream; cereal products; beverages; water; coffee; cappuccino; malt drinks; chocolate flavoured drinks; culinary products and soups.
- composition of the present invention may further contain protective hydrocolloids (such as gums, proteins, modified starches), binders, film forming agents, encapsulating agents/materials, wall/shell materials, matrix compounds, coatings, emulsifiers, surface active agents, solubilizing agents (oils, fats, waxes, lecithins etc.), adsorbents, carriers, fillers, co-compounds, dispersing agents, wetting agents, processing aids (solvents), flowing agents, taste masking agents, weighting agents, jellifying agents, gel forming agents, antioxidants and antimicrobials.
- protective hydrocolloids such as gums, proteins, modified starches
- binders film forming agents, encapsulating agents/materials, wall/shell materials, matrix compounds, coatings, emulsifiers, surface active agents, solubilizing agents (oils, fats, waxes, lecithins etc.), adsorbents, carriers, fillers, co-compounds,
- composition may also contain conventional pharmaceutical additives and adjuvants, excipients and diluents, including, but not limited to, water, gelatine of any origin, vegetable gums, ligninsulfonate, talc, sugars, starch, gum arabic, vegetable oils, polyalkylene glycols, flavouring agents, preservatives, stabilizers, emulsifying agents, buffers, lubricants, colorants, wetting agents, fillers, and the like. In all cases, such further components will be selected having regard to their suitability for the intended recipient.
- conventional pharmaceutical additives and adjuvants, excipients and diluents including, but not limited to, water, gelatine of any origin, vegetable gums, ligninsulfonate, talc, sugars, starch, gum arabic, vegetable oils, polyalkylene glycols, flavouring agents, preservatives, stabilizers, emulsifying agents, buffers, lubricants, colorants, wetting agents, fill
- composition may be a nutritionally complete formula.
- composition according to the invention may comprise a source of protein.
- Any suitable dietary protein may be used, for example animal proteins (such as milk proteins, meat proteins and egg proteins); vegetable proteins (such as soy protein, wheat protein, rice protein, and pea protein); mixtures of free amino acids; or combinations thereof. Milk proteins such as casein and whey, and soy proteins are particularly preferred.
- the proteins may be intact or hydrolysed or a mixture of intact and hydrolysed proteins. It may be desirable to supply partially hydrolysed proteins (degree of hydrolysis between 2 and 20%), for example for animals believed to be at risk of developing cows' milk allergy. If hydrolysed proteins are required, the hydrolysis process may be carried out as desired and as is known in the art. For example, a whey protein hydrolysate may be prepared by enzymatically hydrolysing the whey fraction in one or more steps. If the whey fraction used as the starting material is substantially lactose free, it is found that the protein suffers much less lysine blockage during the hydrolysis process. This enables the extent of lysine blockage to be reduced from about 15% by weight of total lysine to less than about 10% by weight of lysine; for example about 7% by weight of lysine which greatly improves the nutritional quality of the protein source.
- the composition may also contain a source of carbohydrates and a source of fat.
- the fat source preferably provides 5% to 40% of the energy of the composition; for example 20% to 30% of the energy.
- a suitable fat profile may be obtained using a blend of canola oil, corn oil and high-oleic acid sunflower oil.
- a source of carbohydrate may be added to the composition.
- the source of carbohydrates preferably provides 40% to 80% of the energy of the composition.
- Any suitable carbohydrate may be used, for example sucrose, lactose, glucose, fructose, corn syrup solids, maltodextrins, and mixtures thereof.
- Dietary fibre may also be added if desired. Dietary fibre passes through the small intestine undigested by enzymes and functions as a natural bulking agent and laxative. Dietary fibre may be soluble or insoluble and in general a blend of the two types is preferred.
- Suitable sources of dietary fibre include soy, pea, oat, pectin, guar gum, gum Arabic, fructooligosaccharides, galacto-oligosaccharides, sialyl-lactose and oligosaccharides derived from animal milks.
- a preferred fibre blend is a mixture of inulin with shorter chain fructo-oligosaccharides.
- the fibre content is between 2 and 40 g/l of the composition as consumed, more preferably between 4 and 10 g/l.
- the composition may also contain minerals and micronutrients such as trace elements and vitamins in accordance with the recommendations of Government bodies such as the USRDA.
- the composition may contain per daily dose one or more of the following micronutrients in the ranges given:- 300 to 500 mg calcium, 50 to 100 mg magnesium, 150 to 250 mg phosphorus, 5 to 20 mg iron, 1 to 7 mg zinc, 0.1 to 0.3 mg copper, 50 to 200 ⁇ g iodine, 5 to 15 ⁇ g selenium, 1000 to 3000 ⁇ g beta carotene, 10 to 80 mg Vitamin C, 1 to 2 mg Vitamin B1, 0.5 to 1.5 mg Vitamin B6, 0.5 to 2 mg Vitamin B2, 5 to 18 mg niacin, 0.5 to 2.0 ⁇ g Vitamin B12, 100 to 800 ⁇ g folic acid, 30 to 70 ⁇ g biotin, 1 to 5 ⁇ g Vitamin D, 3 to 10 ⁇ g Vitamin E.
- One or more food grade emulsifiers may be incorporated into the composition if desired; for example diacetyl tartaric acid esters of mono- and di-glycerides, lecithin and mono- and di-glycerides. Similarly suitable salts and stabilisers may be included.
- composition is preferably orally or enterally administrable; for example in the form of a powder for re-constitution with milk or water.
- the composition described above may be prepared in any suitable manner. For example, it may be prepared by blending together the protein, the carbohydrate source, and the fat source in appropriate proportions. If used, the emulsifiers may be included at this point. The vitamins and minerals may be added at this point but are usually added later to avoid thermal degradation. Any lipophilic vitamins, emulsifiers and the like may be dissolved into the fat source prior to blending. Water, preferably water which has been subjected to reverse osmosis, may then be mixed in to form a liquid mixture. The temperature of the water is conveniently about 50°C to about 80°C to aid dispersal of the ingredients. Commercially available liquefiers may be used to form the liquid mixture. The liquid mixture is then homogenised; for example in two stages.
- the liquid mixture may then be thermally treated to reduce bacterial loads, by rapidly heating the liquid mixture to a temperature in the range of about 80°C to about 150°C for about 5 seconds to about 5 minutes, for example.
- This may be carried out by steam injection, autoclave or by heat exchanger; for example a plate heat exchanger.
- the liquid mixture may be cooled to about 60°C to about 85°C; for example by flash cooling.
- the liquid mixture may then be again homogenised; for example in two stages at about 10 MPa to about 30 MPa in the first stage and about 2 MPa to about 10 MPa in the second stage.
- the homogenised mixture may then be further cooled to add any heat sensitive components; such as vitamins and minerals.
- the pH and solids content of the homogenised mixture are conveniently adjusted at this point.
- the homogenised mixture is transferred to a suitable drying apparatus such as a spray drier or freeze drier and converted to powder.
- the powder should have a moisture content of less than about 5% by weight.
- the agent that reduces the amount of enterobacteria in the gut may be added in appropriate amounts.
- the agent may also be added at an earlier stage.
- Figure 1 shows the blood glucose levels of a control group and of mice treated with the antibiotics polymyxin B and neomycin after carrying out the experiment of example 1.
- Figure 2 shows the body weight gain of mice after treatment with Lactobacillus rhamnosus CGMCC 1.3724 in accordance with example 2 and of a control experiment.
- Figure 3 shows the number of enterobacteria determined in the feces of a control group and of mice treated with the antibiotics polymyxin B and neomycin after carrying out the experiment of example 1.
- Figure 4 shows the number of enterobacteria determined in the feces of a control group and of mice with Lactobacillus rhamnosus CGMCC 1.3724 after carrying out the experiment of example 2.
- mice Seven to eight weeks-old male obese ob/ob mice were fed a chow diet and treated with 10 9 -10 10 cfu Lactobacillus rhamnosus CGMCC 1.3724 per day for 60 days. Lactobacillus rhamnosus CGMCC 1.3724 biomass diluted in the MRS medium was added to the drinking solution containing 0.9% NaCl. The control group received the saline solution with corresponding amount of MRS medium present in the probiotic preparation. Body weight of the mice was followed during the study. The feces of treated and control ob/ob mice were plated on Drigalski media to determine the number of enterobacteria.
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Abstract
Description
- The present invention relates to the prevention and/or treatment of metabolic disorders. In particular the present invention relates to preventing and/or treating metabolic disorders by modulating, in particular reducing the amount of enterobacteria in the gut.
- The prevalence of obesity has grown in an alarming rate in the past 20 years. Based on the latest estimate in 2004, in the US alone, 66.3% of adults are either overweight or obese, and 32.2% of adults are classified as obese (Cynthia L. Ogden et al., JAMA 2006 April 5;295:1549-1555). Both genetic and environmental factors have been shown to cause positive energy balance and obesity. Obesity by itself is only a part of problems. Many other chronic diseases such as type 2 diabetes, certain cancers and cardiovascular diseases are common co-morbidities of obesity. Collectively, all the obesity associated medical issues put a tremendous amounts of pressure on health care systems in many countries. Due to the prevalence of obesity, type 2 diabetes has also become a worldwide health problem. According to an epidemiological study, the projective global prevalence for type 2 diabetic population will reach to 366 million people in 2030 (Sarah Wild et al., Diabetes Care 2004 May;27:1047-1053). Drug treatments for obesity are available but not very effective and with undesirable side-effects. For the treatment of type 2 diabetes, currently available drugs are capable of managing hyperglycemia of the patients. Still more drugs are under development to improve the safety, efficacy of the medications and convenience to use them by patients. To date, all anti-obesity and anti-diabetic drugs are designed to alter the internal metabolism of patients. Most of these drugs are required to be absorbed and delivered to target organs through blood stream for their efficacy. Safety concerns of such a treatment strategy cannot be ignored. In contrast a novel treatment strategy of obesity and type 2 diabetes focussing on targets outside of human tissues is greatly desirable because the active agents are not required to enter our body, and the safety of the treatments can be improved significantly.
- Human beings are superorganisms with a body composed of millions of human cells while many more bacteria live, e.g., in the colon. It has been estimated that more than 1013 to 1014 bacteria are alive in a healthy human intestine. Intestinal bacteria can be separated into 2 major divisions, firmicutes and bacteroidetes (Steven R. Gill,et al., Science 2006 June 2;312: 1355-1359; Peter J. Turnbaugh, et al., Nature 2006 Dec 21;444:1027-131). Together, they represent at least 90% of total bacterial population in the gut. The presence of the gut bacteria is a part of normal human physiology and is important for the development of gut functions (Hooper LV et al., Science. 2001 Feb 2;291(5505):881-4; Stappenbeck TS, et al., Proc Natl Acad Sci U S A. 2002 Nov 26;99(24):15451-5), maturation of the immune system (Mazmanian SK, et al., Cell. 2005 Jul 15;122(1):107-18), harvesting energy from dietary carbohydrates (Peter J. Turnbaugh, et al., Nature 2006 Dec 21;444:1027-131), harvesting essential vitamins (Backhed F, et al., Science. 2005 Mar 25;307(5717):1915-20) and metabolizing environmental chemicals in the gut (Nicholson JK, et al., Nat Rev Microbiol. 2005 May;3(5):431-8). Recent studies further suggested that gut bacteria may be involved in fat storage (Backhed F, et al., Proc Natl Acad Sci U S A. 2004 Nov 2;101(44):15718-23).
- However, until now it has never been taught or suggested to manipulate the composition of gut bacteria to treat or prevent metabolic disorders. To the best knowledge of the inventors it is so far undescribed in the art that the population of gut bacteria, in particular enterobacteria can be manipulated in order to improve the human health, especially in cases of obesity and/or type 2 diabetes.
- It was one object of the present invention to improve the management of metabolic disorders by a method that does not require that the active agent is absorbed by the body. Instead the present invention aims to modulate the population of bacteria in the intestine of patients.
- Consequently, the object of the present invention is achieved by a use in accordance with
claim 1. - One important aspect of the present invention is to understand the influences of different gut bacteria to human health. The inventors were surprised to find that benefits in the treatment and/or prevention of metabolic disorders, in particular weight control and treatment of type 2 diabetes, can be achieved when gut enterobacteria are specifically reduced.
- Consequently, one aspect of the present invention is to reduce specifically the enterobacteria in the gut is to treat and/or prevent metabolic disorders, in particular to reduce weight gain and improve glucose control in type 2 diabetes.
- To the inventor's best knowledge, the approach of reducing gut enterobacteria as a way to treat and/or prevent metabolic disorders, in particular, has not been disclosed or suggested in the prior art.
- One embodiment of the present invention relates consequently to the use of a primary composition comprising an agent that reduces the amount of enterobacteria in the gut for the preparation of a composition to treat or prevent metabolic disorders.
- In the framework of the present invention "reducing the amount of enterobacteria in the gut" means "reducing the amount of alive enterobacteria in the gut". "Reducing the amount of enterobacteria in the gut" may also include reducing the total amount of enterobacteria, dead or alive, in the gut. "Reducing the amount of enterobacteria in the gut" may also relate to "reducing the amount of dead enterobacteria in the gut.
- Enterobacteria are preferably firmicute and/or bacteroidete.
- Further preferably, enterobacteria may be selected from the group consisting of Alishewanella, Alterococcus, Aquamonas, Aranicola, Arsenophonus, Azotivirga, Blochmannia, Brenneria, Buchnera, Budvicia, Buttiauxella, Cedecea, Citrobacter, Dickeya, Edwardsiella, Enterobacter, Erwinia, Escherichia, Ewingella, Grimontella, Hafnia, Klebsiella, Kluyvera, Leclercia, Leminorella, Moellerella, Morganella, Obesumbacterium, Pantoea, Pectobacterium, Candidatus Phlomobacter, Photorhabdus, Plesiomonas, Pragia, Proteus, Providencia, Rahnella, Raoultella, Salmonella, Samsonia, Serratia, Shigella, Sodalis, Tatumella, Trabulsiella, Wigglesworthia, Xenorhabdus, Yersinia, Yokenella or mixtures thereof.
- Particular examples of metabolic disorders that can be treated or prevented by the above use include obesity, insulin resistance, type-2 diabetes, hyperglycemia, hepatic steatosis and combinations thereof.
- The use of the present invention is further applicable to treat or prevent weight gain.
- "Overweight" is defined for an adult human as having a BMI between 25 and 30.
- "Obesity" is a condition in which the natural energy reserve, stored in the fatty tissue of animals, in particular humans and other mammals, is increased to a point where it is associated with certain health conditions or increased mortality. "Obese" is defined for an adult human as having a BMI greater than 30.
- "Probiotic" means microbial cell preparations or components of microbial cells with a beneficial effect on the health or well-being of the host. (Salminen S, Ouwehand A. Benno Y. et al "Probiotics: how should they be defined" Trends Food Sci. Technol. 1999:10 107-10).
- "Prebiotic" means food substances intended to promote the growth of probiotic bacteria in the intestines. One example of prebiotics is dietary fibers. Dietary fibers are fibers that are non-digestible by the human body.
- "Food grade bacteria" means bacteria that are used and generally regarded as safe for use in food.
- The composition of the present invention may be any composition, for example it may be a medicament. As a medicament usually requires supervision by medical personnel, a medicament has the advantage that the success of the use of the present invention can be carefully monitored and -if necessary- the composition can be custom fitted to the needs of the patient to be treated.
- In a preferred embodiment of the present invention the composition is a food product. Food products have the advantage that the benefits of the present invention would be available to everybody immediately without requiring a medical prescription. The treatment or prevention of metabolic disorders could be initiated at a much earlier stage. Further in a food product the composition prepared by the use of the present invention would be even more pleasant to consume.
- As nowadays metabolic disorders are no longer only a problem of the human population, the food product or the medicament prepared by the use of the present invention may be intended for humans or animals, in particular pets or livestock. Animals may be selected from the group consisting of dogs, cats, pigs, cattle, horses, goats, sheep or poultry. Furthermore, nowadays metabolic disorders are no longer a problem that only concerns the adult population.
- Hence, the compositions prepared by the use of the present invention may be intended for infants, children, adolescents and/or adults.
- The compositions of the present invention exhibit their beneficial effects at any age of the subject to be treated. Since, however, metabolic disorders are still found mainly in the adult population, it is preferred that the composition prepared by the use of the present invention is intended for adult patients, in particular human adults.
- Central to the present invention is the idea of reducing enterobacteria in the gut. Consequently, any agent or method that is capable of reducing enterobacteria in the gut can be used for the purpose of the present invention. It is preferred, however that the agent capable of reducing the amount of enterobacteria in the gut is selected from the group consisting of bacterial phages, prebiotics, food grade bacteria, in particular probiotics, yeasts, phytochemicals, antibiotics and mixtures thereof.
- In the case of bacterial phages it is preferred that the phages are food grade phages. In particular T4 phages, such as ED6, and T7 phages can be successfully applied in the framework of the present invention. Phages have the advantage that they are very specific to targeted bacteria and very stable even after long storage times without losing biological activities. The heat stability of phages makes them suitable for food products that are heated during the production process or during preparation prior to consumption. Furthermore, phagse are stable in a number of different media, including the stomach and gut media.
- Prebiotics may be dietary fibers. Dietary fibers may be selected from the group consisting of fructo-oligosaccharides, galacto-oligosaccharides, xylo-oligosaccharides, isomalto-saccharides, soya oligosaccharides, pyrodextrins, transgalactosylated oligosaccharides, lactulose, beta-glucan, inulin, raffinose, stachyose. Dietary fibers also have the advantage of being resistant to a number of conditions including heating and long storage times. They furthermore may contribute to a treatment in the framework of the present invention by improving gastrointestinal health and by increasing satiety.
- Food grade bacteria are preferably probiotic bacteria and may be selected from the group consisting of Bifidobacterium, lactococcus, streptococcus, enterococcus, lactobacillus; preferentially lactic acid bacteria and bifidobacteria, or mixtures thereof. Yeasts are preferably food grade yeasts and may be selected from the group consisting of saccharomyces boulardii and saccharomyces cerevisiae or mixtures thereof. Food grade bacteria, in particular probiotic bacteria and food grade yeasts have the advantage that they may additionally confer benefits to the patient, in particular to the intestinal flora of the patient. These additional benefits are generally known to those skilled in the art and may include managing lactose intolerance, prevention of colon cancer, lowering cholesterol, lowering blood pressure, improving immune function and preventing infections, reducing inflammation and/or improving mineral absorption.
- Antibiotics may be selected from the group consisting of a class of aminoglycoside antibiotics such as neomycin, kanamycin, streptomycin, a class of polypeptide antibiotics such as polymyxin B, a class of penicillin beta-lactam such as ampicillin and a class of quinolone/fluoroquinolone antibiotics such as ciprofloxacin and norfloxacin. Using antibiotics has the advantage that their dosing can be determined with high accuracy. Furthermore, usually only very small quantities are required to achieve an effect, so that antibiotics are in particular useful for applications in medicaments.
- The agent capable of reducing the amount of enterobacteria in the gut may also be a phytochemical, in particular a phytonutrient. Phytochemicals are plant or fruit derived chemical compounds. "Phytonutrients" refer to phytochemicals derived from edible plants. Using phytonutrients and or phytochemicals has the advantage that the effect of the present invention can be achieved with natural foods or extracts from natural foods without having to add synthesized compounds to the composition prepared by the use of the present invention. In the framework of the present invention the phytochemicals may be selected from the group consisting of phytochemicals from green tea or coffee such as indole, polyphenols, such as epigallocatechin and epigallocatechin gallate or the polymers of such, phytochemicals from black tea such as theaflavin or theaflavin mixtures, tennic acid, procyanidin, phytochemicals from cashew apple flavour such as (E)-2-hexenal, phytochemicals from rosemary, such as carnosol, carnosic acid or rosmarinic acid, or mixtures thereof.
- The primary composition may further comprise a pharmaceutically acceptable carrier. Applicable pharmaceutically acceptable carriers are known to those of skill in the art. The pharmaceutically acceptable carrier may be any carrier known in the field as suitable for pharmaceutical and/or oral application. Suitable pharmaceutical carriers and formulations may include sugars and starches. Additional examples of pharmaceutically acceptable carriers are described, for example, in Remington's Pharmaceutical Sciences (19th ed.) (Genarro, ed. (1995) Mack Publishing Co., Easton, Pa.), the contents of which is herewith incorporated herein by reference.. The addition of a carrier has the advantage that the agent capable of reducing the amount of enterobacteria in the gut is further stabilized for long storage times. Furthermore, exact dosing is facilitated.
- The composition prepared by the use of the present invention may also be formulated as sustained release formulation. This way an increased bioavailability and effectiveness of the agent capable of reducing the amount of enterobacteria in the gut can be achieved.
- Generally, the dosage of the agent capable of reducing the amount of enterobacteria in the gut can be adjusted by those skilled in the art to the designated purpose. Any dose showing an effect is suitable. However, e.g., for probiotic bacteria it is preferred that the composition comprises between 102 and 1012 cells of probiotic per g of the dry weight of the composition. Importantly, for the effectiveness of the agent capable of reducing the amount of enterobacteria in the gut it is not necessarily required that the probiotic bacteria are alive in the composition. The probiotics might also be effective, e.g., by means of their metabolites that they have produced. Using inactive probiotics has the advantage that the amount of active agent can be exactly determined. Furthermore, inactive probiotics are usually very storage stable and easy to incorporate in products.
- However, it is preferred if the probiotics are alive, since in this case they may be able to colonize the intestine and increase their effectiveness through colonization. Consequently, in a preferred embodiment of the present invention the composition comprises between 102 and 1012 cfu of probiotic per g of the dry weight of the composition.
Similarly, it is preferred that the composition comprises between 102 and 1012 pfu of phages per g of the dry weight. - The composition may also comprise between 1 µg - 500 mg prebiotics per g of the dry weight.
- In a further embodiment the composition may comprise between 1 µg - 100 mg antibiotics per g of the dry weight.
- In another embodiment the composition may comprise between 1 µg - 500 mg phytochemicals per g of the dry weight.
- If the composition that is prepared by the use of the present invention is a liquid, in particular a drink, the given amounts should be understood as per g of the final product instead of per g of dry weight.
- Of course, the agents capable of reducing the amount of enterobacteria in the gut may be combined.
- Typical food products that may be prepared in the framework of the present invention may be selected from the group consisting of milk-powder based products; instant drinks; ready-to-drink formulations; nutritional powders; milk-based products, in particular yoghurts or ice cream; cereal products; beverages; water; coffee; cappuccino; malt drinks; chocolate flavoured drinks; culinary products and soups.
- The composition of the present invention may further contain protective hydrocolloids (such as gums, proteins, modified starches), binders, film forming agents, encapsulating agents/materials, wall/shell materials, matrix compounds, coatings, emulsifiers, surface active agents, solubilizing agents (oils, fats, waxes, lecithins etc.), adsorbents, carriers, fillers, co-compounds, dispersing agents, wetting agents, processing aids (solvents), flowing agents, taste masking agents, weighting agents, jellifying agents, gel forming agents, antioxidants and antimicrobials. The composition may also contain conventional pharmaceutical additives and adjuvants, excipients and diluents, including, but not limited to, water, gelatine of any origin, vegetable gums, ligninsulfonate, talc, sugars, starch, gum arabic, vegetable oils, polyalkylene glycols, flavouring agents, preservatives, stabilizers, emulsifying agents, buffers, lubricants, colorants, wetting agents, fillers, and the like. In all cases, such further components will be selected having regard to their suitability for the intended recipient.
- The composition may be a nutritionally complete formula.
- The composition according to the invention may comprise a source of protein.
- Any suitable dietary protein may be used, for example animal proteins (such as milk proteins, meat proteins and egg proteins); vegetable proteins (such as soy protein, wheat protein, rice protein, and pea protein); mixtures of free amino acids; or combinations thereof. Milk proteins such as casein and whey, and soy proteins are particularly preferred.
- The proteins may be intact or hydrolysed or a mixture of intact and hydrolysed proteins. It may be desirable to supply partially hydrolysed proteins (degree of hydrolysis between 2 and 20%), for example for animals believed to be at risk of developing cows' milk allergy. If hydrolysed proteins are required, the hydrolysis process may be carried out as desired and as is known in the art. For example, a whey protein hydrolysate may be prepared by enzymatically hydrolysing the whey fraction in one or more steps. If the whey fraction used as the starting material is substantially lactose free, it is found that the protein suffers much less lysine blockage during the hydrolysis process. This enables the extent of lysine blockage to be reduced from about 15% by weight of total lysine to less than about 10% by weight of lysine; for example about 7% by weight of lysine which greatly improves the nutritional quality of the protein source.
- The composition may also contain a source of carbohydrates and a source of fat.
- If the composition includes a fat source, the fat source preferably provides 5% to 40% of the energy of the composition; for example 20% to 30% of the energy. A suitable fat profile may be obtained using a blend of canola oil, corn oil and high-oleic acid sunflower oil.
- A source of carbohydrate may be added to the composition.
- The source of carbohydrates preferably provides 40% to 80% of the energy of the composition. Any suitable carbohydrate may be used, for example sucrose, lactose, glucose, fructose, corn syrup solids, maltodextrins, and mixtures thereof. Dietary fibre may also be added if desired. Dietary fibre passes through the small intestine undigested by enzymes and functions as a natural bulking agent and laxative. Dietary fibre may be soluble or insoluble and in general a blend of the two types is preferred. Suitable sources of dietary fibre include soy, pea, oat, pectin, guar gum, gum Arabic, fructooligosaccharides, galacto-oligosaccharides, sialyl-lactose and oligosaccharides derived from animal milks. A preferred fibre blend is a mixture of inulin with shorter chain fructo-oligosaccharides. Preferably, if fibre is present, the fibre content is between 2 and 40 g/l of the composition as consumed, more preferably between 4 and 10 g/l.
- The composition may also contain minerals and micronutrients such as trace elements and vitamins in accordance with the recommendations of Government bodies such as the USRDA. For example, the composition may contain per daily dose one or more of the following micronutrients in the ranges given:- 300 to 500 mg calcium, 50 to 100 mg magnesium, 150 to 250 mg phosphorus, 5 to 20 mg iron, 1 to 7 mg zinc, 0.1 to 0.3 mg copper, 50 to 200 µg iodine, 5 to 15 µg selenium, 1000 to 3000 µg beta carotene, 10 to 80 mg Vitamin C, 1 to 2 mg Vitamin B1, 0.5 to 1.5 mg Vitamin B6, 0.5 to 2 mg Vitamin B2, 5 to 18 mg niacin, 0.5 to 2.0 µg Vitamin B12, 100 to 800 µg folic acid, 30 to 70 µg biotin, 1 to 5 µg Vitamin D, 3 to 10 µg Vitamin E.
- One or more food grade emulsifiers may be incorporated into the composition if desired; for example diacetyl tartaric acid esters of mono- and di-glycerides, lecithin and mono- and di-glycerides. Similarly suitable salts and stabilisers may be included.
- The composition is preferably orally or enterally administrable; for example in the form of a powder for re-constitution with milk or water.
- The composition described above may be prepared in any suitable manner. For example, it may be prepared by blending together the protein, the carbohydrate source, and the fat source in appropriate proportions. If used, the emulsifiers may be included at this point. The vitamins and minerals may be added at this point but are usually added later to avoid thermal degradation. Any lipophilic vitamins, emulsifiers and the like may be dissolved into the fat source prior to blending. Water, preferably water which has been subjected to reverse osmosis, may then be mixed in to form a liquid mixture. The temperature of the water is conveniently about 50°C to about 80°C to aid dispersal of the ingredients. Commercially available liquefiers may be used to form the liquid mixture. The liquid mixture is then homogenised; for example in two stages.
- The liquid mixture may then be thermally treated to reduce bacterial loads, by rapidly heating the liquid mixture to a temperature in the range of about 80°C to about 150°C for about 5 seconds to about 5 minutes, for example. This may be carried out by steam injection, autoclave or by heat exchanger; for example a plate heat exchanger.
- Then, the liquid mixture may be cooled to about 60°C to about 85°C; for example by flash cooling. The liquid mixture may then be again homogenised; for example in two stages at about 10 MPa to about 30 MPa in the first stage and about 2 MPa to about 10 MPa in the second stage. The homogenised mixture may then be further cooled to add any heat sensitive components; such as vitamins and minerals. The pH and solids content of the homogenised mixture are conveniently adjusted at this point.
- The homogenised mixture is transferred to a suitable drying apparatus such as a spray drier or freeze drier and converted to powder. The powder should have a moisture content of less than about 5% by weight.
- For example then the agent that reduces the amount of enterobacteria in the gut may be added in appropriate amounts. Depending on the kind of agent that reduces the amount of enterobacteria the agent may also be added at an earlier stage.
- It is clear to those skilled in the art that they can freely combine features described in this disclosure without departing from the scope of the invention as originally disclosed.
- Further advantages and features of the present invention will be apparent to those of skill in the art from the following examples and figures.
-
Figure 1 shows the blood glucose levels of a control group and of mice treated with the antibiotics polymyxin B and neomycin after carrying out the experiment of example 1. -
Figure 2 shows the body weight gain of mice after treatment with Lactobacillus rhamnosus CGMCC 1.3724 in accordance with example 2 and of a control experiment. -
Figure 3 shows the number of enterobacteria determined in the feces of a control group and of mice treated with the antibiotics polymyxin B and neomycin after carrying out the experiment of example 1. -
Figure 4 shows the number of enterobacteria determined in the feces of a control group and of mice with Lactobacillus rhamnosus CGMCC 1.3724 after carrying out the experiment of example 2. - Male C57BL/6J mice at 7 weeks old were put on a high fat diet for 10 weeks. Then, the mice were randomized into 2 groups (n=5), a control and an antibiotics treated group. Polymyxin B and neomycin were dissolved in drinking water. The doses of polymyxin B and neomycin are 0.5 and 1.0 g/L, respectively. The mice were treated with the antibiotic combination for 2 weeks. At the end of treatment period, mice were fasted for 6 hours from 8:00 before sacrifice started. During the sacrifice, blood glucose levels were determined and cecal contents were collected for assessing the composition of gut bacteria. The cecal content of control and antibiotic treated mice were plated on Drigalski media to determine the number of enterobacteria.
- Seven to eight weeks-old male obese ob/ob mice were fed a chow diet and treated with 109-1010 cfu Lactobacillus rhamnosus CGMCC 1.3724 per day for 60 days. Lactobacillus rhamnosus CGMCC 1.3724 biomass diluted in the MRS medium was added to the drinking solution containing 0.9% NaCl. The control group received the saline solution with corresponding amount of MRS medium present in the probiotic preparation. Body weight of the mice was followed during the study. The feces of treated and control ob/ob mice were plated on Drigalski media to determine the number of enterobacteria.
Claims (28)
- Use of a primary composition comprising an agent that reduces the amount of enterobacteria in the gut for the preparation of a composition to treat or prevent metabolic disorders.
- Use in accordance with claim 1 to treat or prevent obesity.
- Use in accordance with one of claims 1-2 to treat or prevent insulin resistance.
- Use in accordance with one of claims 1-3 to treat or prevent type-2 diabetes.
- Use in accordance with one of claims 1-4 to treat or prevent hyperglycemia.
- Use in accordance with one of claims 1-5 to treat or prevent hepatic steatosis.
- Use in accordance with one of claims 1-6 to treat or prevent weight gain.
- Use in accordance with one of claims 1-7, characterized in that the composition is a medicament.
- Use in accordance with one of claims 1-7, characterized in that the composition is a food product.
- Use in accordance with one of claims 8-9, characterized in that the food product or the medicament is intended for humans or animals, in particular pets or livestock.
- Use in accordance with claim 10, characterized in that the animals are selected from the group consisting of dogs, cats, pigs, cattle, horses, goats, sheep and poultry.
- Use in accordance with one of claims 8-11, characterized in that the medicament or the food product is intended for infants, children, adolescents and/or adults.
- Use in accordance with claim 8-12, characterized in that the medicament or the food product is intended for adult humans.
- Use in accordance with one of claims 1-13, characterized in that the agent capable of reducing the amount of enterobacteria in the gut is selected from the group consisting of bacterial phages, prebiotics, food grade bacteria, in particular probiotics, yeasts, phytochemicals, antibiotics and mixtures thereof.
- Use in accordance with claim 14, characterized in that the bacterial phages are selected from the group consisting of food grade phages, in particular T4 phages such as ED6 and T7 phages.
- Use in accordance with claim 14, characterized in that the dietary fibers are selected from the group consisting of fructo-oligosaccharides, galacto-oligosaccharides, xylo-oligosaccharides, isomalto-saccharides, soya oligosaccharides, pyrodextrins, transgalactosylated oligosaccharides, lactulose, beta-glucan, inulin, raffinose, stachyose.
- Use in accordance with claim 14, characterized in that the probiotics and yeasts are selected from the groups consisting of Bifidobacterium, lactococcus, streptococcus, enterococcus, lactobacillus; preferentially lactic acid bacteria and bifidobacteria, or mixtures thereof and the yeasts are selected from the group consisting of saccharomyces boulardii and saccharomyces cerevisiae or mixtures thereof.
- Use in accordance with claim 14, characterized in that the antibiotics are selected from the group consisting of a class of aminoglycoside antibiotics such as neomycin, kanamycin, streptomycin, a class of polypeptide antibiotics such as polymyxin B, a class of penicillin beta-lactam such as ampicillin and a class of quinolone/fluoroquinolone antibiotics such as ciprofloxacin and norfloxacin.
- Use in accordance with claim 14, characterized in that the phytochemicals are selected from the group consisting of phytochemicals from green tea or coffee such as indole, polyphenols, such as epigallocatechin and epigallocatechin gallate or the polymers of such, phytochemicals from black tea such as theaflavin or theaflavin mixtures, tennic acid, procyanidin, phytochemicals from cashew apple flavour such as (E)-2-hexenal, phytochemicals from rosemary, such as carnosol, carnosic acid or rosmarinic acid, or mixtures thereof.
- Use in accordance with claims 1-19, characterized in that the primary composition further comprises a pharmaceutically acceptable carrier.
- Use in accordance with claims 1-20, characterized in that the primary composition is used as a sustained release preparation.
- Use in accordance with claims 1-21, characterized in that the composition comprises between 102 and 1012 cells of probiotic per g of the dry weight of the composition.
- Use in accordance with claims 1-22, characterized in that the composition comprises between 102 and 1012 cfu of probiotic per g of the dry weight of the composition.
- Use in accordance with claims 1-12, characterized in that the composition comprises between 102 and 1012 pfu of phages per g of the dry weight.
- Use in accordance with claims 1-20, characterized in that the composition comprises between 1 µg - 500 mg prebiotics per g of the dry weight.
- Use in accordance with claims 1-20, characterized in that the composition comprises between 1 µg - 100 mg antibiotics per g of the dry weight.
- Use in accordance with claims 1-20, characterized in that the composition comprises between 1 µg - 500 mg phytochemicals per g of the dry weight.
- Use in accordance with claims 9-25, characterized in that the food product is selected from the group consisting of milk-powder based products; instant drinks; ready-to-drink formulations; nutritional powders; milk-based products, in particular yoghurts or ice cream; cereal products; beverages; water; coffee; cappuccino; malt drinks; chocolate flavoured drinks; culinary products and soups.
Priority Applications (12)
Application Number | Priority Date | Filing Date | Title |
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EP07114530A EP2030623A1 (en) | 2007-08-17 | 2007-08-17 | Preventing and/or treating metabolic disorders by modulating the amount of enterobacteria |
CN200880111670A CN101827600A (en) | 2007-08-17 | 2008-07-25 | Preventing and/or treating metabolic disorders by modulating the amount of enterobacteria |
EP08786467A EP2190438A2 (en) | 2007-08-17 | 2008-07-25 | Preventing and/or treating metabolic disorders by modulating the amount of enterobacteria |
MX2010001903A MX2010001903A (en) | 2007-08-17 | 2008-07-25 | Gut flora and weight management. |
PCT/EP2008/059809 WO2009024429A2 (en) | 2007-08-17 | 2008-07-25 | Gut flora and weight management |
SG2014014153A SG2014014153A (en) | 2007-08-17 | 2008-07-25 | Preventing and/or treatingmetabolic disorders by modulatingthe amount of enterobacteria |
AU2008290737A AU2008290737B2 (en) | 2007-08-17 | 2008-07-25 | Preventing and/or treating metabolic disorders by modulating the amount of enterobacteria |
BRPI0815506-2A2A BRPI0815506A2 (en) | 2007-08-17 | 2008-07-25 | INTESTINAL FLORA AND WEIGHT CONTROL |
CN201410328358.7A CN104147052A (en) | 2007-08-17 | 2008-07-25 | Preventing and/or treating metabolic disorders by modulating the amount of enterobacteria |
US12/673,891 US8591880B2 (en) | 2007-08-17 | 2008-07-25 | Gut flora and weight management |
CL2008002422A CL2008002422A1 (en) | 2007-08-17 | 2008-08-14 | Use of a primary composition comprising a proteobacterial reducing agent consisting of polymyxin b and neomycin to treat or prevent metabolic disorders and to maintain the total body weight of a subject. |
ARP080103595A AR067971A1 (en) | 2007-08-17 | 2008-08-15 | USE OF COMPOSITION FOR THE PREVENTION AND / OR TREATMENT OF METABOLIC DISORDERS |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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EP07114530A EP2030623A1 (en) | 2007-08-17 | 2007-08-17 | Preventing and/or treating metabolic disorders by modulating the amount of enterobacteria |
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EP07114530A Withdrawn EP2030623A1 (en) | 2007-08-17 | 2007-08-17 | Preventing and/or treating metabolic disorders by modulating the amount of enterobacteria |
EP08786467A Withdrawn EP2190438A2 (en) | 2007-08-17 | 2008-07-25 | Preventing and/or treating metabolic disorders by modulating the amount of enterobacteria |
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EP08786467A Withdrawn EP2190438A2 (en) | 2007-08-17 | 2008-07-25 | Preventing and/or treating metabolic disorders by modulating the amount of enterobacteria |
Country Status (10)
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US (1) | US8591880B2 (en) |
EP (2) | EP2030623A1 (en) |
CN (2) | CN101827600A (en) |
AR (1) | AR067971A1 (en) |
AU (1) | AU2008290737B2 (en) |
BR (1) | BRPI0815506A2 (en) |
CL (1) | CL2008002422A1 (en) |
MX (1) | MX2010001903A (en) |
SG (1) | SG2014014153A (en) |
WO (1) | WO2009024429A2 (en) |
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MX2010001903A (en) | 2010-04-30 |
AU2008290737A1 (en) | 2009-02-26 |
EP2190438A2 (en) | 2010-06-02 |
BRPI0815506A2 (en) | 2015-02-10 |
CN104147052A (en) | 2014-11-19 |
CL2008002422A1 (en) | 2009-10-23 |
AU2008290737B2 (en) | 2013-11-14 |
CN101827600A (en) | 2010-09-08 |
US20110123501A1 (en) | 2011-05-26 |
WO2009024429A3 (en) | 2009-12-03 |
AR067971A1 (en) | 2009-10-28 |
SG2014014153A (en) | 2014-05-29 |
US8591880B2 (en) | 2013-11-26 |
WO2009024429A2 (en) | 2009-02-26 |
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